Effect of a Purpose in Life on Risk of Incident Alzheimer Disease and Mild Cognitive Impairment in Community-Dwelling Older Persons | Dementia and Cognitive Impairment | JAMA Psychiatry | JAMA Network
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1.
Wang  HXKarp  AHerlitz  ACrowe  MKåreholt  IWinblad  BFratiglioni  L Personality and lifestyle in relation to dementia incidence.  Neurology2009723253259PubMedGoogle Scholar
2.
Fratiglioni  LWang  HXEricsson  KMaytan  MWinblad  B Influence of social network on occurrence of dementia: a community-based longitudinal study.  Lancet2000355921213151319PubMedGoogle Scholar
3.
Fratiglioni  LPaillard-Borg  SWinblad  B An active and socially integrated lifestyle in late life might protect against dementia.  Lancet Neurol200436343353PubMedGoogle Scholar
4.
Wilson  RSSchneider  JAArnold  SEBienias  JLBennett  DA Conscientiousness and the incidence of Alzheimer disease and mild cognitive impairment.  Arch Gen Psychiatry2007641012041212PubMedGoogle Scholar
5.
Frankl  VE Man's Search for Meaning.  New York, NY: Washington Square Press, Simon and Schuster; 1963
6.
Ryff  CDDienberg Love  GUrry  HLMuller  DRosenkranz  MAFriedman  EMDavidson  RJSinger  B Psychological well-being and ill-being: do they have distinct or mirrored biological correlates?  Psychother Psychosom20067528595PubMedGoogle Scholar
7.
Ryff  CD Happiness is everything, or is it? explorations on the meaning of psychological well-being.  J Pers Soc Psychol198957610691081Google Scholar
8.
Stranges  SDorn  JMShipley  MJKandala  NBTrevisan  MMiller  MADonahue  RPHovey  KMFerrie  JEMarmot  MGCappuccio  FP Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study.  Am J Epidemiol20081681213531364PubMedGoogle Scholar
9.
Ryff  CDSinger  BHDienberg Love  G Positive health: connecting well-being with biology.  Philos Trans R Soc Lond B Biol Sci2004359144913831394PubMedGoogle Scholar
10.
Samman  E Psychological and Subjective Wellbeing: A Proposal for Internationally Comparable Indicators. OPHI Working Paper Series.  Oxford, England: Oxford University Press; 2007
11.
Ryff  CDKeyes  CL The structure of psychological well-being revisited.  J Pers Soc Psychol1995694719727PubMedGoogle Scholar
12.
Wrosch  CScheier  MFMiller  GESchulz  RCarver  CS Adaptive self-regulation of unattainable goals: goal disengagement, goal reengagement, and subjective well-being.  Pers Soc Psychol Bull2003291214941508PubMedGoogle Scholar
13.
Abbott  RAPloubidis  GBHuppert  FAKuh  DWadsworth  MECroudace  TJ Psychometric evaluation and predictive validity of Ryff's psychological well-being items in a UK birth cohort sample of women [published online ahead of print October 4, 2006].  Health Qual Life Outcomes2006476PubMeddoi:10.1186/1477-7525-4-76Google Scholar
14.
Boyle  PABarnes  LLBuchman  ASBennett  DA Purpose in life is associated with mortality among community-dwelling older persons.  Psychosom Med2009715574579PubMedGoogle Scholar
15.
Bennett  DASchneider  JABuchman  ASMendes de Leon  CBienias  JLWilson  RS The Rush Memory and Aging Project: study design and baseline characteristics of the study cohort.  Neuroepidemiology2005254163175PubMedGoogle Scholar
16.
Folstein  MFFolstein  SE McHugh  PR Mini-mental state: a practical method for grading the cognitive state of patients for the clinician.  J Psychiatr Res1975123189198PubMedGoogle Scholar
17.
McKhann  GDrachman  DFolstein  MKatzman  RPrice  DStadlan  EM Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease.  Neurology1984347939944PubMedGoogle Scholar
18.
Bennett  DASchneider  JAAggarwal  NTArvanitakis  ZShah  RCKelly  JFFox  JHCochran  EJArends  DTreinkman  ADWilson  RS Decision rules guiding the clinical diagnosis of Alzheimer's disease in two community-based cohort studies compared to standard practice in a clinic-based cohort study.  Neuroepidemiology2006273169176PubMedGoogle Scholar
19.
Aggarwal  NTWilson  RSBeck  TLBienias  JLBennett  DA Motor dysfunction in mild cognitive impairment and the risk of incident Alzheimer disease.  Arch Neurol2006631217631769PubMedGoogle Scholar
20.
Boyle  PAWilson  RSAggarwal  NTTang  YBennett  DA Mild cognitive impairment: risk of Alzheimer disease and rate of cognitive decline.  Neurology2006673441445PubMedGoogle Scholar
21.
Wilson  RSBeckett  LABarnes  LLSchneider  JABach  JEvans  DABennett  DA Individual differences in rates of change in cognitive abilities of older persons.  Psychol Aging2002172179193PubMedGoogle Scholar
22.
Barnes  LLWilson  RSBienias  JLde Leon  CFKim  HJBuchman  ASBennett  DA Correlates of life space in a volunteer cohort of older adults.  Exp Aging Res20073317793PubMedGoogle Scholar
23.
Bennett  DASchneider  JATang  YArnold  SEWilson  RS The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study.  Lancet Neurol200655406412PubMedGoogle Scholar
24.
Gail  MHLubin  JHRubinstein  LV Likelihood calculations for matched case-control studies and survival studies with tied death times.  Biometrika198168703707Google Scholar
25.
SAS Institute Inc SAS 9.1.3 Help and Documentation.  Cary, NC: SAS Institute Inc; 2000
26.
Lindfors  PLundberg  U Is low cortisol level an indicator of positive health?  Stress Health200218153160Google Scholar
27.
Friedman  EMHayney  MLove  GDSinger  BHRyff  CD Plasma interleukin-6 and soluble IL-6 receptors are associated with psychological well-being in aging women.  Health Psychol2007263305313PubMedGoogle Scholar
28.
Ryff  CDSinger  B From social structure to biology integrative science in pursuit of human health and well-being.  In: Snyder  CRLopez  SJ, eds.  Handbook of Positive Psychology. New York, NY: Oxford University Press; 2002:541-555Google Scholar
29.
Cechetto  DFHachinski  VWhitehead  SN Vascular risk factors and Alzheimer's disease.  Expert Rev Neurother200885743750PubMedGoogle Scholar
30.
Pinquart  M Creating and maintaining purpose in life in old age: a meta-analysis.  Ageing Int200227290114Google Scholar
31.
Geda  YERoberts  ROKnopman  DSPetersen  RCChristianson  TJPankratz  VSSmith  GEBoeve  BFIvnik  RJTangalos  EGRocca  WA Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study.  Arch Gen Psychiatry2008651011931198PubMedGoogle Scholar
32.
Peters  KRRockwood  KBlack  SEHogan  DBGauthier  SGLoy-English  IHsiung  GYJacova  CKertesz  AFeldman  HH Neuropsychiatric symptom clusters and functional disability in cognitively-impaired not-demented individuals.  Am J Geriatr Psychiatry2008162136144PubMedGoogle Scholar
Original Article
March 2010

Effect of a Purpose in Life on Risk of Incident Alzheimer Disease and Mild Cognitive Impairment in Community-Dwelling Older Persons

Author Affiliations

Author Affiliations: Rush Alzheimer's Disease Center (Drs Boyle, Buchman, Barnes, and Bennett) and Departments of Behavioral Sciences (Drs Boyle and Barnes) and Neurological Sciences (Drs Buchman, Barnes, and Bennett), Rush University Medical Center, Chicago, Illinois.

Arch Gen Psychiatry. 2010;67(3):304-310. doi:10.1001/archgenpsychiatry.2009.208
Abstract

Context  Emerging data suggest that psychological and experiential factors are associated with risk of Alzheimer disease (AD), but the association of purpose in life with incident AD is unknown.

Objective  To test the hypothesis that greater purpose in life is associated with a reduced risk of AD.

Design  Prospective, longitudinal epidemiologic study of aging.

Setting  Senior housing facilities and residences across the greater Chicago metropolitan area.

Participants  More than 900 community-dwelling older persons without dementia from the Rush Memory and Aging Project.

Main Outcome Measures  Participants underwent baseline evaluations of purpose in life and up to 7 years of detailed annual follow-up clinical evaluations to document incident AD. In subsequent analyses, we examined the association of purpose in life with the precursor to AD, mild cognitive impairment (MCI), and the rate of change in cognitive function.

Results  During up to 7 years of follow-up (mean, 4.0 years), 155 of 951 persons (16.3%) developed AD. In a proportional hazards model adjusted for age, sex, and education, greater purpose in life was associated with a substantially reduced risk of AD (hazard ratio, 0.48; 95% confidence interval, 0.33-0.69; P < .001). Thus, a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was approximately 2.4 times more likely to remain free of AD than was a person with a low score (score = 3.0, 10th percentile). This association did not vary along demographic lines and persisted after the addition of terms for depressive symptoms, neuroticism, social network size, and number of chronic medical conditions. In subsequent models, purpose in life also was associated with a reduced risk of MCI (hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .02) and a slower rate of cognitive decline (mean [SE] global cognition estimate, 0.03 [0.01], P < .01).

Conclusion  Greater purpose in life is associated with a reduced risk of AD and MCI in community-dwelling older persons.

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